Discharge Checklist. Patient Education Transplant Services. For a kidney/pancreas transplant

Transcription

1 Patient Education Discharge Checklist For a kidney/pancreas transplant Are you ready to leave the hospital with your new kidney or pancreas? You will want to make sure you have done all the necessary planning to make your transplant successful. Before you proceed through this checklist, you should review the following chapters: Chapter 14: UWMC Clinic Care After Discharge Chapter 15: Life After Transplant

2 Discharge Checklist Page 13-2 I will be able to leave the hospital when I know: How and When to Contact the Transplant Team with Concerns When to call for questions and concerns: There is an experienced transplant team member on-call 24 hours a day. You may have questions or need to report a problem after you arrive home. You will need to call the transplant coordinator if you have any of the following: Fever: Temperature greater than 100 degrees F (38.0 degrees C). Pain: Increasing pain, especially abdominal pain. Wound: Redness, tenderness, swelling or drainage from incision. Nausea, vomiting, diarrhea or inability to keep medications or fluids down. Urine: Inability to void or sudden decrease in urine output (kidney transplant), bloody urine, or pain with urination.

3 Page 13-3 Discharge Checklist Blood sugar: Blood sugars over 250mg/dl (pancreas transplant) or blood sugars regularly over 300mg/dl. Constipation: No bowel movement for over 48 hours or if you notice blood in your bowel movements. Questions about medication administration: Dosing instructions, missed doses or other concerns. Whom to call for questions and concerns: Life-threatening emergencies any time: Call 911. Weekdays (8 a.m. to 5 p.m., Monday through Friday): Call my transplant coordinator. My transplant coordinator is: Phone number: Weekend/Holiday/Nights emergent or urgent concerns: Call (page) the kidney or pancreas transplant doctor on-call. UWMC Paging Operator phone number:

4 Discharge Checklist Page 13-4 For help with housing, transportation, or emotional support: Call the Transplant Social Worker, Housing Where I am staying: At home If not at my home, I will be staying with or at: Phone number: Transportation Who will drive me to and from my appointments? My Post Discharge Appointments Lab (blood draw): The Lab is located on the third floor of the hospital. You do not need an appointment. Lab request slips will be given to you or called to the lab. The Lab is open from 7:30 a.m. to 6:00 p.m. Monday through Friday. You should plan to have your blood drawn on clinic appointment days (M, W, F) between 7:30 a.m. and 8:00 a.m. If your coordinator requests blood work

5 Page 13-5 Discharge Checklist to be drawn after hours, you need to report to the Evening Blood Draw lab on the second floor of the hospital. Transplant Clinic: Your transplant coordinator or transplant resident will arrange your first appointment for you. Return appointments can be made at the clinic reception desk or by calling or your transplant coordinator. General Transplant Knowledge Know the signs and symptoms of kidney transplant rejection: Weight gain. Fluid retention (swelling of feet). Decrease in urine output. Fever. Pain or swelling over the transplant site. Flu-like symptoms or just feeling lousy (fatigue, aches, fever). Increased blood levels of creatinine.

6 Discharge Checklist Page 13-6 Know the signs and symptoms of pancreas transplant rejection: Increased levels of serum amylase or lipase. If bladder drained, decreased urinary amlyase. Flu-like symptoms (fatigue, aches, fever). Elevated blood glucose levels. Know the signs and symptoms of infection: Fever and chills. Sore throat. Burning or pain with urination. Shortness of breath or coughing. Nausea or vomiting. Fatigue. Congestion. Red skin areas.

7 Page 13-7 Discharge Checklist General Self Care Have a bowel movement (must have one before discharge). Empty my bladder (if not on dialysis). Properly care for my wound. Provide proper care to my vascular access site. Activity Walk in the hallway 3 to 4 times a day. Go up and down stairs (if there are stairs at home). Know physical activity limits. Equipment Have a scale to measure weight. Have a thermometer to measure oral temperature. Have a blood pressure machine/cuff to measure blood pressure (may also measure pulse). Have a glucometer to measure blood sugar (those with diabetes or high blood sugars).

8 Discharge Checklist Page 13-8 Record Keeping Take and record blood pressure, temperature, pulse. Times/day Check blood sugar (pancreas transplant or diabetic). Times/day Take weight once daily (morning). Record intake of fluids and output of urine (total for each day). 30cc = 1 ounce 240cc = 8 ounces (1 cup) 1000cc = 32 ounces (1 quart) Record labs: Creatinine (Cr), Potassium (K), blood and urine Amylase (pancreas transplant patients), anti-rejection drug levels. Collect 12-hour urine samples (pancreas transplant patients). Record insulin doses and adjust, if needed (if diabetic). Food or protein intake if instructed by dietitian. Keep track of medication changes and make changes to mediset.

9 Page 13-9 Discharge Checklist Diabetics Check and record blood sugars at least twice daily. Give myself insulin injections. Record insulin doses, adjust if needed. Know signs and symptoms of hyperglycemia/hypoglycemia. Diet Keep food and liquids down without vomiting. Eat adequate amounts of food for wound healing. Discuss dietary needs and restricted foods. Make a diet plan. Medications State the name and doses of the antirejection medications I am taking. Make adjustments in the doses of my medications as directed by my doctor. Fill my medication box (mediset) and take medications on my own. Receive my discharge medication prescriptions. Have a plan for filling my discharge medication prescriptions.

10 Discharge Checklist Page Notes

11 Page Discharge Checklist Notes

12 Discharge Checklist Page Questions? Your questions are important. Call your transplant coordinator during business hours Box N.E. Pacific St., Seattle, WA University of Washington Medical Center 03/2003 Rev. 01/2005